Obesity Prevention Programs in Children: Impact on Weight, Shape and Food Concern

Stigma Experienced by Children and Adolescents With Obesity

The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.

[Effectiveness of combined interventions for the prevention of overweight for children and youths : A systematic review]

BACKGROUND

Prevalence rates of overweight children and youths remain high meaning that preventive measures are still necessary. Combined interventions are rated highly in the field of overweight prevention, particularly with regard to the key areas of diet, physical activity and life skills.

OBJECTIVES

It is our aim to give an overview of current studies with combined interventions for the prevention of overweight, to derive comprehensive insights and to identify knowledge gaps.

METHODS

A systematic review of combined interventions for 6-16 year old children and youths forms the basis of this contribution. Twelve data bases, the internet and references were searched for controlled studies. Study quality was appraised with the EPHPP-tool; if randomisation was present the risk of bias was assessed. Studies with the explicit aim of preventing overweight were analysed separately.

RESULTS

Thirteen studies remained from 12,136 screened titles. Interventions were school-based and occasionally different intervention sites were linked to each other. All 13 interventions involved measures focusing on diet, physical activity and life skills; measures targeting structures and conditions were inadequately represented. The duration of intervention and follow-up time points varied widely. More than half of the studies reported positive effects on body mass index.

CONCLUSIONS

The number of published controlled studies with combined interventions is surprisingly low. With regard to the prevention of overweight, the potential of life skills programs seems not yet to be exhausted; measures targeting structures and conditions are insufficiently utilised.